Restenosis after coronary stenting--incidence and predictors.

ABSTRACT

OBJECTIVE: To determine the intermediate term outcome after coronary artery stenting. METHODS: The six month angiographic and clinical follow-up of 92 consecutive patients (94 lesions) undergoing successful coronary stenting was performed. Multiple variables were analyzed for predicting restenosis. RESULT: The mean age was 49.7 +/- 8.5 years. There were 73 males and 19 females. Coronary artery involvement was left anterior descending artery (LAD) in 67%, left circumflex artery (LCx) in 16.5% and right coronary artery (RCA) in 16.5%. The pre-procedure mean reference diameter was 3.1 +/- 0.38 mm, minimal luminal diameter (MLD) was 0.47 +/- 0.28 mm and percentage diameter stenosis (DS) was 85 +/- 9%. Post procedure MLD improved to 3.1 +/- 0.4 mm with an acute gain of 2.6 +/- 0.4 mm and residual DS of only 3 +/- 3%. Clinical and angiographic variables were correlated with restenosis assessed as both binary and continuous variables. Angiographic follow-up could be obtained in 55 out of 92 patients (60%) and 86 patients (88%) had a clinical follow-up. Angiographic restenosis (> 50% diameter stenosis) was present in 12 (22%) patients, seven of whom required a repeat angioplasty procedure. There was no death. At follow-up, the MLD was 2.1 +/- 0.93 and the DS was 32 +/- 29% with a lumen loss of 0.92 +/- 0.84 mm. Only 14 (16%) of patients had angina and stress test was positive in 21 (23%). Hypercholesterolemia (p < 0.001) and female gender (p < 0.05) were independently associated with high lumen loss. CONCLUSION: Intracoronary stenting in an unselected patient group is associated with a 22% restenosis rate. Hypercholesterolemia and female gender are associated with higher restenosis.